| Doctor Name: | MR. ROBERT JOSEPH LOOTENS |
| NPI Number: | 1023131570 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNAO |
| License Number: | |
| Business Practice Address: | 1705 Christy Dr Suite 103 Jefferson City, MO - 651015195 |
| Business Phone Number: | 5736351333 |
| Business Fax Number: | 5736350529 |
| Mailing Address: | 1705 Christy Dr, Suite 103 JEFFERSON CITY |
| State: | MO |
| Postal Code: | 651015195 |
| Phone Number: | 5736351333 |
| Fax Number: | 5736350529 |
| NPI Enumeration Date: | 04/09/2007 |
| NPI Last Update Date: | 03/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |